A Systematic Evaluation of Mobile Health Applications for the Prevention of Suicidal Behavior or Non-suicidal Self-injury

Sander, Lasse; Lemor, Marie-Luise; Sloot, Racine J. A. Van der; Jaegere, Eva De; Büscher, Rebekka; Meßner, Eva-Maria; Baumeister, Harald; Terhorst, Yannik

doi:10.3389/fdgth.2021.689692

Cited by 15 publications

(10 citation statements)

References 51 publications

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“…However, there was continued improvement was exhibited in the mSTART condition, perhaps due to increased exposure to and subsequent retention of skills. These findings add to the growing literature (Jiménez-Muñoz et al, 2022;Sander et al, 2021) on digital tools for suicide prevention by presenting results from a controlled trial. In future iterations of mSTART, improving the user experience and app would be beneficial following feedback from participants.…”

Section: Discussionmentioning

confidence: 60%

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Depp¹,

Parrish²,

Chalker³

et al. 2023

Psychiatric Rehabilitation Journal

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Objective: People with serious mental illnesses (SMIs) are at high risk for suicidal ideation and behavior, and yet few suicide prevention interventions have been customized for this group. We describe the outcomes of a pilot trial of Mobile SafeTy And Recovery Therapy (mSTART), a four-session suicide-focused cognitive behavioral intervention for SMI, designed for the transition from acute to outpatient care and augmented with ecological momentary intervention to reinforce intervention content. Methods: The primary objective of this pilot trial was to evaluate the feasibility, acceptability, and preliminary effectiveness of START. Seventy-eight people with SMI and elevated suicidal ideation were randomized to either: (a) mSTART or (b) START alone (i.e., without mobile augmentation). Participants were evaluated at baseline, 4 weeks (end of in-person sessions), 12 weeks (end of mobile intervention), and 24 weeks. The primary outcome of the study was change in suicidal ideation severity. Secondary outcomes included psychiatric symptoms, coping self-efficacy, and hopelessness. Results: A total of 27% of randomized persons were lost to follow-up after baseline, and engagement with mobile augmentation was variable. There was clinically significant improvement (d = 0.86) in suicidal ideation severity scores sustained over 24 weeks, with similar effects seen for secondary outcomes. Preliminary comparison indicated a medium effect size (d = 0.48) advantage at 24 weeks of mobile augmentation in suicidal ideation severity scores. Treatment credibility and satisfaction scores were high. Conclusions and Implications for Practice: START, regardless of mobile augmentation, was associated with sustained improvement in suicidal ideation severity and secondary outcomes in people with SMI at-risk for suicide in this pilot trial. Impact and ImplicationsThis pilot study tested a new brief intervention designed to target suicide ideation in at-risk people with SMIs, focusing on the gap period between urgent and ongoing care. We found that the intervention, which included both in-person and mobile technology components, was feasible, acceptable, and linked with sustained improvement in suicide ideation. Although a pilot study, this research suggests that brief suicidespecific interventions adapted for people with SMIs could be helpful in bridging acute to outpatient care.

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Section: Discussionmentioning

confidence: 60%

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Depp¹,

Parrish²,

Chalker³

et al. 2023

Psychiatric Rehabilitation Journal

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“…The strength of our work was to provide a wide overview of the apps that specifically aim to manage and monitor suicide crisis and prevent suicide in clinical and non-clinical samples. In fact, we analyzed published original studies on the feasibility, acceptability and efficacy of mobile apps, while some reviews have only assessed the main features of apps available in Android and iOS stores to test their usability and engagement [ 21 , 22 , 23 , 24 , 66 , 67 , 68 ]. Our target was exclusively suicide risk, while other papers [ 14 , 69 , 70 ] included mental health in general.…”

Section: Discussionmentioning

confidence: 99%

“…However, evidence of the effectiveness of apps in reducing suicide ideation, plans and attempts remains unclear, and most of the apps currently available lack clinically validated evidence of their efficacy [ 16 ]. Moreover, previous systematic reviews [ 16 , 17 , 18 ] have analyzed only a small number of the articles about suicide prevention apps, providing a partial view of the available literature, while others [ 21 , 22 , 23 , 24 ] have directly assessed apps downloaded from the Android and iOS app stores to screen and examine the general features, the inclusion of educative elements and evidence-based assessment of suicide risk, and the strategies to manage suicidal thoughts incorporated in these apps. As highlighted by De La Torre and colleagues [ 24 ], the number of apps regarding suicide prevention is relatively small, and there is still little information available from literature searches, indicating that technology-based suicide prevention remains understudied.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Mobile Apps for Monitoring and Management of Suicide Crisis: A Systematic Review of the Literature

Sarubbi

Rogante

Erbuto

et al. 2022

JCM

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Suicide risk is a multifaceted phenomenon, and many risk factors are involved in its complexity. In the last few decades, mental health apps have spread, providing economic and affordable strategies to prevent suicide. Therefore, the aim of this review is to identify original studies on mobile apps that target suicidal crises. The review follows PRISMA guidelines, searching through four major electronic databases (PubMed/MEDLINE, Scopus, PsycInfo and Web of Science) for relevant titles/abstracts published from January 2010 to May 2022. It includes original studies that explicitly analyze mobile apps for suicide prevention. A total of 32 studies met the inclusion criteria. Sixteen studies assessed the feasibility and acceptability of mobile apps, ten studies assessed the efficacy of mobile apps in preventing suicide, and six studies described randomized control trial protocols not yet implemented. Generally, the apps were judged by participants to be acceptable and helpful, and several improvements to enhance the functionality of apps were suggested. The efficacy of mobile apps, although limited and assessed with very heterogenous methods, was confirmed by most of the studies. Mobile apps could represent a helpful supplement to traditional prevention tactics, providing real-time monitoring of at-risk persons, personalized tools to cope with suicidal crises, and immediate access to specific support.

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“…Sometimes, to escape the societal stigma associated with suicide thoughts, people may use online platforms such as blogs, tweets, and forums to express themselves (Larsen, Nicholas and Christensen, 2016;Sander et al, 2021). Indeed, including smartphones and social data in NLP models may enhance suicide diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Mobile health applications (MHA) offer the potential to expand access to evidence-based care for those who have suicidal thoughts by addressing some of the constraints that are present in traditional mental health therapy (Sander et al, 2021). These obstacles include stigmatisation, the perception that expert treatment is not required, and an inadequate time in an acute suicidal crisis.…”

Section: Digital Applications For Suicide Detectionmentioning

confidence: 99%

Application of Natural Language Processing (NLP) in Detecting and Preventing Suicide Ideation: A Systematic Review

Arowosegbe¹,

Oyelade²

2022

Preprint

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Introduction: Around a million people are reported to die by suicide every year, and due to the stigma associated with the nature of the death, this figure is usually assumed to be an underestimate. Suicide may be prevented if prompt intervention is taken to mitigate risk. Machine learning and artificial intelligence-based modelling, such as natural language processing (NLP) and other text analytics approaches, has the potential to become a major technique for the detection, diagnosis, and treatment of people who are suffering from mental health issues. The primary aims of this research are to determine whether NLP techniques have been utilised in the field of suicide prevention, and if so, were they effective? What were their limitations? Methods: PubMed, EMBASE, MEDLINE, PsycInfo, and Global Health databases were searched for studies that reported use of NLP for suicide ideation or self-harm. Thematic analysis was used to synthesise and analyse the included studies. Findings were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, and the Mixed Methods Appraisal Tool (MMAT) was used in assessing paper quality. Result: The preliminary search of five databases generated 387 results. Removal of duplicates resulted in 158 potentially suitable studies. Twenty papers were finally included in this review. Discussion: Studies show that combining structured and unstructured data in NLP data modelling yielded more accurate results than utilizing either alone. Also, to reduce suicides, people with mental problems must be continuously and passively monitored. Further, NLP and other machine learning/artificial intelligence technologies can be used to address health inequities and electronic health records provide valuable data for creating suicide risk tools. Finally, Online, social media, and smartphone applications can be leverage in detecting people with suicide ideation. Conclusion: The use of artificial intelligence and machine learning opens new avenues for considerably guiding risk prediction and advancing suicide prevention frameworks. The review's analysis of the included research revealed that the use of NLP may result in low-cost and effective alternatives to existing resource-intensive methods of suicide prevention. To summarise, there is substantial evidence that NLP is useful in identifying people who have suicide ideation.

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A Systematic Evaluation of Mobile Health Applications for the Prevention of Suicidal Behavior or Non-suicidal Self-injury

Cited by 15 publications

References 51 publications

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

Pilot feasibility trial of a brief mobile-augmented suicide prevention intervention for serious mental illness.

The Effectiveness of Mobile Apps for Monitoring and Management of Suicide Crisis: A Systematic Review of the Literature

Application of Natural Language Processing (NLP) in Detecting and Preventing Suicide Ideation: A Systematic Review

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